Treating pediatric liver tumors in India a challenging proposition.

Of 825 pediatric malignancies diagnosed at our institution between 2005 and 2012, 13 (1.6%) had primary liver tumors. The median age was 4 years (2 mo 15 yrs), 9 males. In 12 cases (92.3%), a malignant primary was present of which hepatoblastoma was the commonest, seen in 8(67%) cases. Hepatocellular carcinoma (HCC) was diagnosed in 3(25%) and undifferentiated embryonal sarcoma(UES) in 1(8%). Mesenchymal hamartoma was identified in 1 child. For hepatoblastoma and HCC risk stratification was done according to PRETEXT criteria and SIOPEL-3 chemotherapy protocol was used [2]. Serum alfafetoprotein (AFP) was measured in all cases and serially monitored.